MEDICARE: DAKODA WHITAKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst		TX
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1790326874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAKODA WHITAKER

Provider Business Mailing Address
First Line	:	1111 SHEPHERD DR APT 425
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-4698
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18502 GREEN LAND WAY STE D
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-7967
Country	:	US
Telephone Number	:	713-594-8250
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2019
Last Update Date	:	09/24/2025

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Directions to “ DAKODA WHITAKER ” Practice Location

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